Socket shield, Aesthetic Buccal flap for Apicoectomy, Osseodensification, and immediate placement

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Posted on By narayan tv In Implants

40 y old male
Cast post core on 14, repeated de-cementation.
Periapical lesion on 14,thin buccal plate. Socket shield followed by apicoectomy via an aesthetic buccal flap, osseodensification with Densah followed by installation of a 4.3X13 Nobel Active.




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11 Comments

Narajan,
Great job! The planning and use of different tools are very interesting and final result very nice.
You mentioned the new bone around implant produced by Versah drill: what is, in your opinion, the fate of that bone, between shield and implant?
Thanks for sharing.
Armando


Reply

Narayan. Outstanding case study and execution! I am looking forward to seeing the long term outcome. My personal observation and preference would have been a more palatal implant position. The main concern being potential shield complications. Was this your planed position or a consequence of drilling protocol? Well done my friend. Thank you for sharing. Chuck


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Very provocative....breaking barriers. Thanks Mo


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Thanks Maurice, for your comments. That's the spirit of Xp isn't it? To challenge the limits! Cheers and the best for NYU


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Thanks Chuck , for your comments. I enjoy your incisive observations . This was my planned implant position . With the jumping distance from the shield I imagined I would be safe even in the event of a shield failure ? Will update final restoration in due course.


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Thanks for your comments Armando. I'd imagine the bone that fills the gap will essentially behave like a particulate autogenous and undergo resorption to be replaced by new bone ?


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Thanks for your comments Armando. I'd imagine the bone that fills the gap will essentially behave like a particulate autogenous and undergo resorption to be replaced by new bone ?


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Narayan, a great case. SS+apicoectomy. Very predictable.
I´ve done many cases and all of them successfully. My only concern is like Chuck´s concern. The little buccaly orientation of the implant. Do you think that you could do a screwed prosthesis?
Wel done!
Regards
Jorge


Reply

Jorge, I look forward to your comments. The implant is emerging in the centre of the ridge and considering itsba premolar , I should be able to screw retain comfortably? The Postop CBCT sections show the labiolingual position as fairly central to the ridge. Thanks again for the inputs. Will update in due course


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Narayan, I like your case treatment, especially Densah burs osteotomie.
I`ve also done SS with apicoectomy, the only (little) difference is that I used VISTA like approach, instead of aesthetic buccal flap.
Best regards and thank you for sharing
Snjezana


Reply

Thanks Snezana. That's an interesting approach. What is the perceived advantage of the Tunnel procedure here?


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